I was diagnosed with Sjogren's about 18 months ago based on symptoms and bloodwork results showing extremely high Sjogren's antigen numbers (both of them were in the 1,000). I have been on Plaquinal and prednisone, among all of the other medicines I am on. I have been having swollen parotid glands and other swelling of minor salivary glands on my right side for about 6 months. I developed a mass under my tongue (noticed it in August) that grew rather rapidly to a tall (over an inch) mass that literally would fold under because of the weight of my tongue on top of it. I saw my Rheumy who sent me to an ENT doc. She was very concerned and recommended surgery to remove it and to biopsy it. On my request, I also asked to have a Sjogren's biopsy done on another salivary gland to confirm the Sjogren's diagnosis. The biopsy came back and ENT doc said based on the biopsy "There are no features of neoplasm in the mass" and that the mass was just that, a fibrosis mass. She could not tell us why it was there, could it come back, should we expect more to come back other places, etc. She also said that the second biopsy to confirm the Sjogren's was not done well and did not give her any answers. In her words the biopsy was "A lazy biopsy". Here is what the two biopsy said and I would like to know if anyone can help explain what this means:
1) On the mass : "The inflammatory cells are mainly foamy histiocytes and lymphocytes. Large lymphoid aggregates are also present. The salivary glands are atrophic and surrounded by inflammation and fibrosis".
2) On the 2nd biopsy of the additional salivary gland tissue says this: "The second specimen shows lobular salivary gland with severe lymphocytic infiltrate and lymphoid aggregates with glandular atrophy. There is also increase fibrosis in the salivary gland.
Can someone help explain what these mean - since my highly paid ENT doc had no clue truely what they meant? Also, should I see my Rheumy again and see if she can help explain what these mean? Should I be concerned with lymphoma because of the mass?
Thanks in advance for any help from ya'll.
Cindy
Sjogren's patient in Texas
No neoplasm, generally means it is not cancerous. It looks benign. That said, pathologists do sometimes dance around in their wording.
Lymphocytic infiltration is just that, lymphocytes in your tissue, which is inflammation.
My salivary gland biopsy says, lymphocyctic infiltration. With highly positive blood work, I would think you have a classic case of SjS.
Hi ceckols :)
Welcome to Sjogren's world!
It seems to me that you have the symptoms and also the bloodwork/labwork for Sjogren's so I'm glad you're ebing treated for it. That growth must have been very alarming but it must be good news that's it's not cancerous.
I hope you find the site useful.
Take care - Scottie :)
I agree with Inga.
At the SJS seminar I attended this past weekend, one doctor explained that with SJS, lymphocytes are attracted to the gland, but they have ?no right? to be there because that?s ?not where they live.? As a result, they replace healthy glandular tissue and our glands are less effective.
"Large lymphoid aggregates are also present" and "severe lymphocytic infiltrate and lymphoid aggregates with glandular atrophy" sound to me like it's exactly what she was talking about.